Medicaid Director Clarifies Home Health Services

Lincoln – Nebraska Medicaid Director Vivianne Chaumont would like to correct the misinformation circulating about Medicaid services for people with disabilities who live in the community. The Department of Health and Human Services (DHHS) has prepared a fact sheet to respond to the inaccurate information.

“The Nebraska Medicaid program is 100-percent committed to paying for services so that people can live as independently as possible in the community, if that is their choice,” said Chaumont, Director of the DHHS Division of Medicaid and Long-Term Care. “On the other hand, our duty to all Nebraskans is to make sure these services are at the right level, in the right amount and for the right cost. We have a responsibility to use limited tax dollars in the most appropriate ways so that Medicaid can continue to serve eligible Nebraskans.”

Accomplishing that balance is one reason Chaumont is contracting with Qualis, a private nonprofit federally-designated quality improvement organization to review the cases. Qualis has an office in Lincoln and employs long-time Nebraska nurses and a Nebraska physician as its medical director.

A variety of Medicaid community-based services are already available to best meet the level of service that’s necessary to provide care in the least-restrictive manner. Home health will continue to be an available option to provide such care.

Nebraska Medicaid community-based service options currently include home health care, Medicaid Aged and Disabled Waiver, and Personal Assistant Services (PAS). In fact, Chaumont said Nebraska’s new Money Follows the Person program helps Medicaid-enrolled individuals who are residing in nursing homes or Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) transition to independent living in community-based settings.

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Facts and Myths

Nebraska DHHS Medicaid and Home Health Care Services

Myth: The only reason Medicaid is making changes in home health services is for cost savings.

Fact: DHHS is committed to serving people with disabilities in the community with the right level of service, in the right amount and at the right cost. This is not only a Medicaid standard of compliance but it is our responsibility to use limited tax dollars in the most appropriate ways so that Medicaid can continue to serve eligible Nebraskans.

Myth: These cases are being reviewed by an out-of-state contractor.

Fact: Medicaid has a contract with Qualis Health, a private nonprofit federally-designated Quality Improvement Organization, who has an office in Lincoln. While Qualis is headquartered in Seattle, Washington, it has offices in six states including Nebraska. The Nebraska office has existed since 2007 and employs long-time Nebraska nurses and a Nebraska physician as its medical director.

Myth: The Medicaid Program is making changes that will force people with disabilities into nursing homes.

Fact: The Medicaid Program is committed to providing services in the community. We do not want people to move into a nursing facility if that is not their choice. In addition, nursing home services are often more expensive than community-based services. Our focus is on serving people with disabilities in the community with the right level of service, in the right amount and at the right cost. Medicaid has no reason to want to move people into nursing homes if that is not the appropriate level of service.

Myth: DHHS is not committed to community-based services.

Fact: DHHS is committed to serving people with disabilities in the community and a variety of community-based services are already available to best meet the level of service that’s necessary to provide care in the least-restrictive manner. Home health will continue to be an available option to provide such care.

Nebraska Medicaid community-based service options currently include home health care, Medicaid Aged and Disabled Waiver, and Personal Assistant Services (PAS). In fact, Nebraska’s new Money Follows the Person program helps Medicaid-enrolled individuals who are residing in nursing homes or Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR), transition to independent living in community-based settings.